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Although North Carolina trails behind most states in implementing best practices in tobacco control, from a low cigarette tax, to smoking bans, and low spending for tobacco prevention and control initiatives, it has found one area to be a leader in: Tobacco Free Hospitals, including grounds. Hospital administrators from across North Carolina -- in small mountain towns, large cosmopolitan areas, and at the beach -- have stepped up to address the health and economic costs of tobacco use and exposure to secondhand smoke.
In 2003 the first North Carolina hospital passed a tobacco-free grounds policy, and as of February 2007, 59 more hospitals have followed suit. This means more than 75% of the acute care hospitals in the state have gone 100% tobacco-free. Charlotte-based Carolinas Healthcare System (CHS) and Presbyterian Hospital (Novant Health) joined this group of hospitals in October, 2006, and April, 2007 respectively. Their policies are similar; both hospitals have completely banned the use of all tobacco products anywhere on their properties for all employees, patients, visitors, volunteers, students, contractors, etc. They also require that employees no longer use tobacco products while on paid time.
A policy that may have seemed unthinkable even just five years ago has now become the norm across the state. And according to a survey of CHS employees conducted by the Mecklenburg County Health Department, the vast majority are supportive. Overall, 87% of employees either agreed or strongly agreed with the policy. As expected, smokers were more likely to disagree than non-smokers. Only 11.4% of employees claimed to be using tobacco products at the time the policy was announced. This number is closely in line with numbers from the state Behavioral Risk Factor Surveillance System which report that only 10.8 % of Mecklenburg County residents smoke every day.
Of the employees who said they used tobacco products when the policy was first announced, 50% said that the policy influenced them to quit smoking or to cut down on tobacco use. Since that time, 43% have decreased tobacco use and 15% have quit smoking. Comments left on the survey were overwhelmingly positive and supportive. A large number of comments expressed that this policy was exactly in line with the mission of healthcare providers and a number said it was “long overdue.” A handful expressed gratitude that their employer cared enough about their health to pass this policy. Other people said that productivity has increased since smokers in their area were no longer leaving for smoke breaks.
The CDC estimates that every employee who uses tobacco costs an additional $3400 in direct medical costs and lost productivity. Using that calculation, this policy change will likely save the company at least $880,600 per year, $362,600 just from direct medical costs. This research demonstrates that even in a state that has been slow to implement tobacco restrictions, a tobacco free hospital policy makes sense and is appreciated by employees. Concerns that turnover would increase have not come to fruition. The data shows that implementing a relatively simple and low cost policy can have a large impact on employee health and healthcare costs from tobacco use.
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